Individual
MR. PHILLIP JOHN SHYERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 S TREATY RD, MIAMI, OK 74354-5326
(918) 540-1511
(918) 542-7374
Mailing address
120 S TREATY RD, MIAMI, OK 74354-5326
(918) 540-1511
(918) 542-7374
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100732380C
—
OK
Enumeration date
07/30/2012
Last updated
09/18/2013
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